Laying the groundwork for Nepal Initiative


AO Alliance raises awareness at ORTHOCON 2017, plans needs assessment

The AO Alliance (AOA) works in low- and middle-income countries (LMICs) with high incidence of injuries and insufficient healthcare resources to address the treatment of trauma or fractures. Nepal ”“ a beautiful landlocked country in South Asia ”“ is one of the selected LMICs (in Asia and Africa) on which AO Alliance has chosen to focus.

Nepal is a challenging environment for access to proper trauma care: among many factors, the country has several remote and mostly difficult-to-access areas, which makes for complicated delivery of care for the injured. Fractures and musculoskeletal injuries contribute to the mortality burden in Nepal and undoubtedly remain a major reason for residual disability in the country. Unfortunately, the dearth of adequate trauma data in LMICs hampers the effort to place fractures and musculoskeletal injuries on the public health agenda in these countries.

This year, the AO Alliance will conduct a needs assessment exercise as foundation for its Country Initiative in Nepal, which involves the education and professional development of healthcare personnel to build local capacity and help improve trauma care in the long run.

ORTHOCON 2017 AO Alliance symposium

The Nepal Orthopedic Association, Annual Congress, ORTHOCON 2017, offered AO Alliance an opportunity to highlight its initial activities in Nepal and Asia through a dedicated symposium, held on February 16, 2017, and chaired by Dr Mahesh Shrivastava, AOA Asia Fellowship Coordinator. ORTHOCON 2017, held in Kathmandu, Nepal, featured a distinguished panel of local and international experts and attracted 200 participants.

During the symposium, Dr med Claude Martin jr. (AO Alliance Managing Director) outlined the overarching fracture care education program in eight low-income countries in Asia, including Nepal. The 3-year initiative aims to deliver appropriate fracture care education to many different types of healthcare workers.

Dr med Claude Martin jr. (AOA Managing Director) presenting AO Alliance Fracture Solutions Project Asia at ORTHOCON 2017

Professor Ram Kewal Shah (Head, Department of Orthopaedics, Nepal Medical College) painted a picture of the state of trauma care in Nepal, and called for collaboration through a broader country initiative to improve care of the injured. Professor Ramesh Prasad Singh (Principal, Nepal Medical College & Teaching Hospital) detailed the AO Alliance Education activities in Nepal and stressed the substantial added value of the national and regional fellowship programs. In addition, he encouraged the young surgeons in the audience to apply to the fellowship programs.

To close the AO Alliance symposium, Professor Heiner Winker (Orthopedic Surgeon, University of Erfurt, Germany) who has been going to Nepal for the last 3 years on a reverse fellowship opportunity at the Dhulikhel Hospital ”“ Kathmandu University Hospital, shared his testimony on the success of instilling AO principles of fracture management combined with some Germanic rigidity. Professor Winker has been fortunate to be able to train two fellows, one from Myanmar and one from Bangladesh, as well as local trainees, nurses and other healthcare professionals.

(L to R) Professor Heiner Winker from Germany, Dr SMA Rahim from Bangladesh (AOA Fellow from Bangladesh), Dr Mahesh Shrivastava (AOA Asia Fellowship Coordinator), Dr Kyaw Thu (AOA fellow from Myanmar) and Dr med Claude Martin jr.

Preparatory meeting for the AOA Country Initiative in Nepal

Following the success of the AO Alliance symposium at ORTHOCON 2017, Alliance representatives, Nepal Ministry of Health (MoH) officials, the Swiss Ambassador to Nepal, Dr Jörg Frieden, and select clinicians reassembled on the evening of February 16, 2017, in Kathmandu. The meeting was held to prepare for AOA’s Country Initiative in Nepal.

(L to R) Mr Jay Kishor Lal, Dr Ram Shah, Mr Bhakta Joshi, Dr med Claude Martin jr.

The meeting attendees discussed the possibilities for a more integrated and coordinated trauma plan for Nepal and agreed to convene for a needs assessment exercise on June 9-10, 2017. In line with its mission, the AO Alliance will be tapped to provide much-needed fracture care education to Nepal’s existing and future healthcare workers. This help will be especially valuable in line with the MoH’s plans of establishing seven national Level 1 trauma centers.

Dr Bhola Ram Shrestha from Ministry of Health
Mr Bhogendra Dotel from Ministry of Health
Dr Martin thanks Mr Dotel for his speech

The needs assessment exercise itself will require a tremendous amount of work, and will need the indispensable collaboration of the MoH and other NGOs active in trauma care in Nepal. It is hoped that the exercise will set the groundwork and jumpstart the AOA Country Initiative in Nepal, which will ultimately promote local capacity building, improve injury prevention strategies and provide better healthcare for the injured.

Meeting attendees